Ramblings of an Emergency Physician in Texas

New Orleans Patients arrive in Fort Worth

I worked an afternoon shift in my ED today, and the buzz was all about the New Orleans transfers we’d received, and continued to receive.

Our joint got about 12 that I’m aware of, with a very high percentage being dialysis patients and in need of that service. It was entirely appropriate that they were sent to us, as we’re one of a few hospitals in the area with inpatient dialysis services available. Our nephrologists didn’t bat an eye, and worked hard to get them taken care of.

The patients were flown into the JRC Fort Worth (used to be Carswell AFB), and then a team from the county hospital and the county EMS director started divvying them up.

The patients I cared for showed what you’d expect in a debilitated, chronically ill person with no adequate sanitation for 3 days. All but one showed up with their inpatient hospital chart (in the binder), and one had not just that but prior charts dating back several years!

The staff, who would gripe even if struck with a new stick, were quite remarkably compassionate and there were no harsh statements made about the sending facilities’ care.

Another flight was due in this evening, but I left before that batch of patients arrived.

A moment of levity in all this: one patient, evacuated with just a gown and a chart arrived with a bottle in hand: a bottle of Tabasco sauce. When asked, yes, it was the patients’ just to make sure it was available for meals.

That should prove interesting for the hospital dietitians.

And now: where in the world are all these cities and hospitals going to put these new patients with chronic illnesses? My place routinely holds admitted patients in the ED hallways. There are no empty hospitals waiting for new patients.

Comments

Up here in Boston I’m getting e-mails about what our hospital is trying to do but I’m sort of out of the loop – we are going about trying to see how we can accomodate pathology residents in our department if needed from training programs that can’t handle them, and volunteers are offering to house them.

Dr, Cole,
Thanks for your offer, but I’m probably the wrong one to ask. From my grunt’s eye view, we’re hanging in there, and everyone is getting cared for.

Speculation alert: I figure we’re in for another 5 days or so of evacuated hospitalized folks, then our storm surge will be done. But just like the hurricane, it’s the flood of folks who will be needing every concieveable community service that’s going to be taxing.

Yep… we’ve seen a large influx of refugees in our hospital too (and we’re hundreds of miles from New Orleans). In our case, however, they’ve all brought themselves.

Many of them evacuated with no medicines. We’ve had patients show up at our door who were scheduled for valve replacements this week in New Orleans… they’re completely displaced and on their own. Fortunately, our medical staff has stepped to the plate and leaned forward to care for these people.

On the other side of the coin, we had a patient on 02 and 20+ medicines who was determined to go back to New Orleans. Even though this person would have no power for their concentrator, or any way to refill their oxygen tanks, she was absolutely dead-set on returning to the city.

That’s the root problem in much of this madness… nobody is using good sense.

A physician was on the local news (here in Houston) around 1 am this morning asking for more physicians and nurses to please come to the Astrodome as they were overwhelmed. His exact words, “Those that are saying we have enough staff here are delusional.” The medical staff in Houston are doing an amazing job caring for so many people. Hopefully they are getting some relief. There certainly is no lack of people that want to help – but the city had asked people to not just show up at the Astrodome or it would be an even bigger mess – coordination is the biggest issue here at the moment.

I know that everyone is posting/reading/thinking about this. Here are a few links that are interesting. Grunt Doc talks about patients coming into his Fort Worth Hospital. He also had a link to satellite before and after pictures. The most…